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The Hour

Surgeons in Norwalk provide pro bono operations for uninsured cancer patients

Hour Staff Writer | Posted: Monday, May 18, 2015 6:30 pm


NORWALK —  Norwalk surgeons often perform pro bono operations on patients without insurance coverage, local doctors say. 

“This is, unfortunately, not that uncommon,” said Norwalk surgeon Dr. Jeanne Capasse, who has performed mastectomies for free on uninsured patients with breast cancer.

“With Obamacare, certainly a lot more people are covered, but there are still some women in our community who are uninsured,” said Capasse. “All of us physicians provide care when it’s needed. We want to take care of everybody.”

In one such recent case, Capasse performed a pro bono double mastectomy on a young woman with breast cancer, and local reconstructive surgeon Dr. Mark Melendez donated a breast reconstruction procedure.

“It’s really hard as a young woman to go through a mastectomy and to lose the breasts, and so it’s nice to be able to offer reconstruction with it, too,” Capasse said. “It really makes women feel whole again, when they’re dealing with this kind of a diagnosis.”

When surgeons want to offer pro bono service, they need to collaborate with a hospital that is willing to contribute resources for the operation, said Melendez, who sits on the board of the Connecticut chapter of the Susan G. Komen Foundation.

For the aforementioned mastectomy, Norwalk Hospital was willing to provide an environment, equipment, and staffing for the procedure, according to Melendez.

“It was quite obvious that (Norwalk Hospital administrators) were very supportive in providing services to patients such as this one, who was uninsured and (wanted) to have a mastectomy followed by reconstructive surgery.”

Connecticut has the highest incidence rate of breast cancer of any state in the country, Melendez said, a fact corroborated by a 2011 study published by the National Cancer Institute.

“It’s well known, you look at any resource as far as demonstrating incidences of cancer throughout the states, and specifically breast cancer, you’ll se it,” Melendez told The Hour.

(The District of Colombia has the highest incidence rate of any region in the U.S.; Connecticut is followed closely by Massachusetts and New Hampshire, according to the National Cancer Institute study.)

Melendez added that in his line of work, he sees certain “discrepancies and disparities” among Connecticut breast cancer patients; some towns have disproportionately high mortality rates, or disproportionately high rates of late-stage diagnosis, according to research published by the Komen Foundation in 2011.

In Fairfield County, according to the Komen study, breast cancer mortality and late-stage diagnosis rates seemed to concentrate in urban areas: Norwalk, Danbury, Bridgeport and environs, and Stamford.

Both Melendez and his colleague, Connecticut Susan G. Komen Foundation CEO Anne Morris, said these statistics seem related to socioeconomic factors.

“In the urban areas, or some of the more low-income areas, we found language barriers,” Morris said. “(Speaking) English as a second language always makes it difficult to understand your options. A lot of the medical interpretation is done via telephone now, which probably isn’t the best way to do that, because it’s difficult to explain something as complex as breast cancer and the different options available over the telephone when somebody’s speaking to you in a language you don’t understand.”

Such language barriers may cause a woman with breast cancer to hesitate before seeking medical help, resulting in a late-stage diagnosis, which is more difficult to treat, Morris said. The situation is even more complex for somebody who is in the country without documentation and doesn’t even have access to the Medicaid program, Morris added.

Despite such correlations, it is difficult to pin down causes of these discrepancies in a meaningful way, Melendez said.

“There’s many reasons. There’s many causes of breast cancer,” Melendez said. “Breast cancer in itself is multifactorial.”

As far as providing surgery to people who can’t afford it, Melendez said, “it’s part of my practice.”

“I took the Hippocratic Oath, by which I believe we should treat all patients, irrelevant to their status as far as insured or uninsured, and that’s where I feel I differ in my practice than others in … Connecticut.”

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